A capitalist system is based on a decision that the distribution of goods and services is best decided by open markets, competition, and private or corporate ownership of the means of production.1 In the real world these markets often function under imposed restraints, usually in place to maintain competition but occasionally to allow scarce, life-sustaining resources to reach all members of a society. This competition restricts profits and allows a high level of efficiency. The opposite would be state-controlled allocation, in which decisions are made from the top down. Such a system creates multiple problems, as illustrated by Herzlinger.
Blumberg MZ. Ethics and Managed Care Can Coexist With a Free Market. Arch Intern Med. 1999;159(12):1375-1376. doi: